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The impact of early cytomegalovirus infection after kidney transplantation on long‐term graft and patient survival
Author(s) -
Smedbråten Yuliya V.,
Sagedal Solbjørg,
Leivestad Torbjørn,
Mjøen Geir,
Osnes Kåre,
Rollag Halvor,
Reisæter Anna V.,
Foss Aksel,
Os Ingrid,
Hartmann Anders
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12288
Subject(s) - medicine , cytomegalovirus , transplantation , kidney transplantation , univariate analysis , human cytomegalovirus , prospective cohort study , surgery , multivariate analysis , betaherpesvirinae , chronic allograft nephropathy , cohort , immunology , viral disease , herpesviridae , virus
This prospective observational cohort study is an extension of a previous study reporting effects of cytomegalovirus ( CMV ) on graft and patient survival in 471 patients who underwent kidney transplantation between 1994 and 1997. CMV pp65 antigen was measured every 7–14 d during the first three months after transplantation, given as number of CMV pp65‐positive cells per 10 5 leukocytes. A positive test was defined as CMV infection. None of the patients received CMV prophylaxis or preemptive treatment. During a median of 13.7 (7.1–14.9) yr, the number of death‐censored graft losses was 118 (25%) and of patient deaths 224 (48%). CMV infection was an independent significant risk factor for mortality in multivariate analysis ( HR = 1.453, 95% CI 1.033–2.045, p = 0.032), adjusting for patient and donor age, preemptive transplantation, HLA ‐ DR and ‐ AB mismatches, living donor, acute rejection during the first three months, donor–recipient CMV IgG antibody status and diabetic nephropathy. In univariate analysis, CMV infection was significantly associated with death‐censored graft loss but the association was not significant in multivariate model. CMV infection early after kidney transplantation is a predictor of overall mortality but not of death‐censored graft loss after a median observation period of 13.7 yr.